Lower extremity and humerus procedures except hip, foot and femur with complications
What 493 hospitals in the U.S. charged and were paid for a Medicare hospital stay for lower extremity and humerus procedures except hip, foot and femur with complications (DRG 493), from 2024 Medicare claims.
Average charge
$124,600
Hospital list price billed
Average payment
$22,820
Medicare + patient + other payers
Medicare paid
$18,731
Average per stay
Volume
10,223
Medicare hospital stays
Hospitals in the U.S. billed an average of $124,600 for lower extremity and humerus procedures except hip, foot and femur with complications, about 5.5 times the average total payment of $22,820.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $22,820Billed $124,600
About 18¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Delray Medical CenterDelray Beach, FL | $15,221 |
|---|---|
| Boone Hospital CenterColumbia, MO | $15,404 |
| Forrest General HospitalHattiesburg, MS | $15,571 |
| McLeod Regional Medical CenterFlorence, SC | $15,685 |
| Iowa Methodist Medical CenterDes Moines, IA | $16,102 |
| Deaconess Hospital INCEvansville, IN | $16,176 |
| Mercy Hospital SouthSt Louis, MO | $16,215 |
| Stormont-Vail HealthcareTopeka, KS | $16,238 |
| Methodist Stone Oak HospitalSan Antonio, TX | $16,316 |
| Baylor Regional Medical Center at GrapevineGrapevine, TX | $16,356 |
Highest
| University of California Davis Medical CenterSacramento, CA | $50,589 |
|---|---|
| University of Maryland Medical CenterBaltimore, MD | $46,477 |
| Johns Hopkins Bayview Medical CenterBaltimore, MD | $44,047 |
| UCI Health-OrangeOrange, CA | $42,819 |
| Hackensack University Medical CenterHackensack, NJ | $42,595 |
| Stanford HospitalPalo Alto, CA | $42,079 |
| Montefiore Medical CenterBronx, NY | $39,582 |
| New York-Presbyterian HospitalNew York, NY | $39,324 |
| Grady Memorial HospitalAtlanta, GA | $39,112 |
| Jersey Shore University Medical CenterNeptune City, NJ | $33,523 |
Lower extremity and humerus procedures except hip, foot and femur with complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Alabama | 7 | $119,901 | $21,693 | $14,984 – $31,638 |
| Alaska | 2 | $124,127 | $30,359 | $28,279 – $33,330 |
| Arizona | 14 | $144,269 | $20,611 | $16,743 – $31,016 |
| Arkansas | 6 | $63,024 | $18,143 | $15,579 – $22,154 |
| California | 40 | $199,960 | $30,547 | $19,128 – $56,854 |
| Colorado | 7 | $148,514 | $20,422 | $17,039 – $25,463 |
| Connecticut | 4 | $88,234 | $27,135 | $24,775 – $28,876 |
| Delaware | 1 | $84,974 | $22,492 | – |
| Florida | 45 | $174,756 | $19,414 | $15,221 – $28,249 |
| Georgia | 8 | $147,599 | $23,106 | $18,417 – $39,112 |
| Hawaii | 1 | $130,651 | $32,893 | – |
| Idaho | 3 | $77,431 | $18,809 | $17,589 – $20,298 |
| Illinois | 25 | $101,272 | $21,748 | $16,505 – $42,529 |
| Indiana | 10 | $102,736 | $19,436 | $15,955 – $24,760 |
| Iowa | 3 | $95,755 | $18,757 | $16,102 – $23,008 |
| Kansas | 5 | $115,652 | $19,081 | $16,238 – $21,334 |
| Kentucky | 6 | $111,829 | $22,279 | $17,156 – $27,636 |
| Louisiana | 6 | $106,553 | $19,201 | $14,725 – $26,497 |
| Maine | 2 | $84,652 | $21,805 | $20,066 – $22,712 |
| Maryland | 11 | $38,941 | $35,084 | $19,639 – $46,477 |
| Massachusetts | 10 | $75,560 | $27,238 | $19,211 – $38,737 |
| Michigan | 12 | $71,581 | $21,093 | $17,465 – $28,642 |
| Minnesota | 14 | $70,440 | $21,852 | $15,870 – $32,402 |
| Mississippi | 4 | $63,810 | $18,317 | $15,571 – $23,639 |
| Missouri | 14 | $84,104 | $19,787 | $15,404 – $30,962 |
| Montana | 2 | $66,131 | $18,898 | $18,282 – $19,322 |
| Nebraska | 5 | $86,555 | $20,030 | $14,663 – $27,031 |
| Nevada | 3 | $180,610 | $23,318 | $21,899 – $26,039 |
| New Hampshire | 2 | $170,682 | $24,633 | $21,117 – $27,928 |
| New Jersey | 14 | $153,868 | $28,688 | $18,557 – $60,665 |
| New Mexico | 3 | $79,712 | $24,619 | $20,227 – $27,654 |
| New York | 19 | $155,224 | $30,118 | $19,838 – $39,582 |
| North Carolina | 12 | $98,445 | $22,112 | $15,816 – $31,202 |
| North Dakota | 2 | $59,056 | $18,957 | $18,311 – $19,327 |
| Ohio | 17 | $105,867 | $20,717 | $16,543 – $26,373 |
| Oklahoma | 5 | $141,913 | $21,158 | $19,008 – $29,207 |
| Oregon | 8 | $88,258 | $24,851 | $20,885 – $29,497 |
| Pennsylvania | 26 | $129,595 | $21,646 | $16,619 – $30,445 |
| Rhode Island | 1 | $59,010 | $25,355 | – |
| South Carolina | 13 | $130,172 | $20,331 | $15,452 – $27,445 |
| South Dakota | 3 | $84,651 | $19,933 | $17,872 – $23,181 |
| Tennessee | 14 | $102,549 | $20,211 | $14,032 – $32,851 |
| Texas | 38 | $151,775 | $21,391 | $15,742 – $48,286 |
| Utah | 5 | $65,512 | $20,483 | $17,657 – $24,159 |
| Virginia | 18 | $106,827 | $20,271 | $14,221 – $29,308 |
| Washington | 6 | $111,051 | $23,640 | $19,098 – $33,082 |
| West Virginia | 5 | $75,727 | $18,908 | $17,758 – $20,509 |
| Wisconsin | 8 | $90,958 | $21,576 | $15,387 – $25,395 |
| Wyoming | 1 | $100,188 | $22,330 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Gulf Coast Medical Center Lee HealthFort Myers, FL | 78 | $110,427 | $17,493 |
| Lehigh Valley HospitalAllentown, PA | 66 | $150,197 | $21,640 |
| Massachusetts General HospitalBoston, MA | 63 | $118,743 | $29,081 |
| Adventhealth OrlandoOrlando, FL | 56 | $182,530 | $23,315 |
| Barnes Jewish HospitalSt Louis, MO | 56 | $98,129 | $23,884 |
| Christiana Care Health Services, INC.Newark, DE | 55 | $84,974 | $22,492 |
| Stanford HospitalPalo Alto, CA | 49 | $334,706 | $42,079 |
| Cedars-Sinai Medical CenterLos Angeles, CA | 49 | $365,418 | $29,870 |
| Sarasota Memorial HospitalSarasota, FL | 49 | $130,693 | $18,043 |
| St Mary's HospitalMadison, WI | 49 | $77,932 | $17,974 |
| University of California Davis Medical CenterSacramento, CA | 48 | $308,616 | $50,589 |
| NYU Hospitals CenterNew York, NY | 48 | $244,341 | $33,100 |
| New Hanover Regional Medical CenterWilmington, NC | 47 | $79,564 | $20,301 |
| Riverside Regional Medical CenterNewport News, VA | 47 | $60,607 | $18,691 |
| Orlando Regional HealthcareOrlando, FL | 46 | $194,307 | $19,726 |
Questions
How much does lower extremity and humerus procedures except hip, foot and femur with complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for lower extremity and humerus procedures except hip, foot and femur with complications (DRG 493) at 493 hospitals in the U.S. was billed at $124,600 on average, while the average total payment was $22,820, of which Medicare paid $18,731. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for lower extremity and humerus procedures except hip, foot and femur with complications?
Among states with at least three hospitals reporting, the average total payment was highest in Maryland ($35,084), California ($30,547), New York ($30,118) and lowest in Arkansas ($18,143), Mississippi ($18,317), Iowa ($18,757).
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in the U.S., average charges were 5.5 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.